| NPI | 1720191109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM ALEXANDER WILSON Clinic Director 501-753-1616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AR P8709020) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: AR P0108037) |
| 103TC0700X Psychologist Clinical (Licence: AR 75-23P) | |
| 1041C0700X Social Worker Clinical (Licence: AR 989-C) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: AR C-6813) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-08-22 |